title: Blood-aqueous barrier after mechanical or nonmechanical excimer laser trephination in penetrating keratoplasty.
abstract: OBJECTIVE
  To analyze whether nonmechanical trephination with an excimer laser influences post-operative blood-aqueous barrier breakdown after penetrating keratoplasty.
  
  
  METHODS
  Patients undergoing penetrating keratoplasty for keratoconus or Fuchs dystrophy were prospectively randomly assigned to trephination by either excimer laser or conventional mechanical handheld motorized trephine. All surgery was performed by one surgeon, and preoperative, intraoperative, and postoperative treatment was identical in both groups. Aqueous flare was quantitatively determined postoperatively in a masked fashion by laser flare-cell meter. For statistical analysis, the nonparametric Wilcoxon-Mann-Whitney test was used.
  
  
  RESULTS
  A total of 52 eyes of 52 patients were examined (Fuchs dystrophy, 10; keratoconus, 42). During the early postoperative period (days 3 to 9), eyes that had undergone nonmechanical excimer laser trephination (25/52) showed significantly (P < .005) lower flare values than did eyes that had undergone mechanical trephination (27/ 52). In both groups, flare values returned to normal levels by 6 weeks postoperatively.
  
  
  CONCLUSIONS
  Early postoperative blood-aqueous barrier breakdown is less pronounced after penetrating keratoplasty with nonmechanical excimer laser trephination.
authors.affiliation: Department of Ophthalmology, University Erlangen-Nürnberg, Germany. michael.kuechle@augen.med.uni-erlangen.de
authors.forename: M
authors.initials: M
authors.lastname: Küchle
authors.forename: N X
authors.initials: NX
authors.lastname: Nguyen
authors.forename: B
authors.initials: B
authors.lastname: Seitz
authors.forename: A
authors.initials: A
authors.lastname: Langenbucher
authors.forename: G O
authors.initials: GO
authors.lastname: Naumann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001082:Aqueous Humor / Q000166:cytology; D018916:Blood-Aqueous Barrier; D002199:Capillary Permeability; D003315:Cornea / Q000601:surgery*; D005260:Female; D005642:Fuchs' Endothelial Dystrophy / Q000601:surgery*; D006801:Humans; D007640:Keratoconus / Q000601:surgery*; D015948:Keratoplasty, Penetrating / Q000009:adverse effects / Q000379:methods*; D053685:Laser Therapy; D007834:Lasers; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies